Provider Demographics
NPI:1154538189
Name:IRWIN SAVODNIK, M.D. & MEDICAL ASSOC., INC.
Entity type:Organization
Organization Name:IRWIN SAVODNIK, M.D. & MEDICAL ASSOC., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVODNIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-517-1717
Mailing Address - Street 1:2780 SKYPARK DR
Mailing Address - Street 2:SUTIE 260
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5341
Mailing Address - Country:US
Mailing Address - Phone:310-517-1717
Mailing Address - Fax:310-517-9853
Practice Address - Street 1:2780 SKYPARK DR
Practice Address - Street 2:SUTIE 260
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5341
Practice Address - Country:US
Practice Address - Phone:310-517-1717
Practice Address - Fax:310-517-9853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24825103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty